Accessible Format Request

Required fields are marked with asterisks (*)

Documents found on our website may be made available in a variety of accessible formats. To request information in an alternative format, please fill out the form fields below.

Contact Information

First Name:

Last Name:

Email Address:

Phone Number:

Street Address:

City/Town:

Postal Code:

Document Information

Please use the fields below to describe the document that you would like to convert, and the format you would like it converted to.

Document Name:

Document location. Provide links to webpages if possible:

Attach document if possible (10MB max)

Browse…

Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Preferred document format:

Printed in a larger size or font

Alternate electronic format (Word, html, rich text, PDF)

Alternate language (ASL, LSQ, plain language, non-english)

Audio alternative

Other

Privacy Statement:

Personal information on this form is collected under the authority of the Municipal Act, 2001 P.S.O. c.45, and will be used to answer your request. Questions about the collection of this information can be directed to the Manager of Legislative Services/Clerk, Municipality of Leamington, 111 Erie Street North, Leamington, N8H 2Z9, Telephone: 519-326-5761.

Please confirm your acknowledgment of document request:

Yes, I acknowledge my request for an accessible format document request.

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